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British Journal of Anaesthesia, 2001, Vol. 86, No. 5 669-673
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Autologous blood transfusion in total knee replacement surgery

D. Thomas1, K. Wareham1, D. Cohen2 and H. Hutchings1

1Morriston Hospital, Swansea NHS Trust, Swansea SA6 6NL, UK. 2University of Glamorgan, Pontypridd CF37 1DL, UK*Corresponding author

We compared allogeneic blood usage for two groups of patients undergoing total knee replacement surgery (TKR). Patients were randomized to receive either their post-operative wound drainage as an autotransfusion (n=115) after processing or to have this wound drainage discarded (n=116). Allogeneic blood was transfused in patients of either group whose haemoglobin fell below 9 g dl–1. Only 7% of patients in the autotransfusion group required an allogeneic transfusion compared with 28% in the control group (P<0.001). There was no hospital mortality and only 3% mortality from all causes at the study completion, which spanned 6 months to 3 yr. There was a higher incidence of infection requiring intervention in the allogeneic group (P<0.036). Total patient costs were £113 greater in the autotransfusion group. We conclude that in this type of surgery post-operative cell salvage is a safe and effective method for reducing allogeneic blood use.

Br J Anaesth 2001; 86: 669–73


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